Physiological and behavioral defenses against hypoglycemia

Decrements in insulin and increments in glucagon are lost and increments in epinephrine and neurogenic symptoms are often attenuated in insulin-deficient - T1DM and advanced T2DM.

SNS: sympathetic nervous system; PNS: parasympathetic nervous system; NE: norepinephrine; ACh: acetylcholine; α-cell: pancreatic islet α-cells; _β -cell: pancreatic islet _β -cells.

Reproduced with permission from: Cryer PE. Mechanisms of sympathoadrenal failure and hypoglycemia in diabetes. J Clin Invest 2006; 116:1470. Copyright ©2006 American Society for Clinical Investigation.

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